Various medical procedures, particularly cardiology procedures, involve accessing a corporeal vessel or other lumen through a percutaneous sheath. The access to the vessel necessarily requires the formation of a hole or puncture in the vessel wall so that a medical procedure can be performed. After the particular medical procedure has been performed, the sheath and other tools must eventually be removed from the vessel and the access hole in the vessel wall must be closed.
A number of prior vascular closure devices have been developed to close the hole in the vessel wall. Closing the hole in the vessel wall typically involves packing a resorbable sealing plug at the hole or sandwiching the hole between the sealing plug and an anchor. Examples of prior vascular closure devices are described in U.S. Pat. Nos. 6,179,863; 6,090,130; and 6,045,569 and related patents that are hereby incorporated by reference.
However, prior to a successful deployment of the sealing plug or another vascular tool, the insertion sheath must be properly located within the vessel or other lumen. Proper placement of the insertion sheath enables proper placement of the sealing plug or insertion of a vascular tool.
According to conventional techniques, proper placement of the insertion sheath is accomplished with the aid of a puncture locator. Typically, the puncture locator and the insertion sheath are inserted partially through the hole in the vessel wall. The puncture locator includes a fluid communication path between distal (where the puncture locator enters the vessel) and proximal ends thereof, such that blood flow can be observed by an operator when the distal end enters the vessel. As the sheath penetrates the vessel wall, blood flows through the fluid communication path and out of a drip hole. Blood continues to flow through the puncture locator until the sheath and/or puncture locator are removed from the vessel. Usually the orientation between the puncture locator and the insertion sheath can be fixed, such that locating the puncture with the puncture locator also properly places the insertion sheath.
Usually the sealing plug is placed at the hole via a sealing device that is inserted through the properly placed insertion sheath. The sealing plug is packed at the hole by manually tamping the sealing plug toward the hole with a tamping tube. The sealing plug most often provides a sufficient seal of the hole as a result of the tamping. However, the sealing plug tends to expand, move, or reposition itself following the tamping operation. Sometimes the repositioning of the sealing plug compromises the seal, and bleeding occurs. In addition, sometimes the sealing plug is over-tamped, pushing a portion of the plug into the vessel which may result in complications. Therefore, there is a need for an improved vascular sealing device that prevents over-tamping and repositioning of the sealing plug to more effectively seal the hole.